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to remain independent as long as possible but if what they get is a significant amount of technology that is in a restrictive setting that may be contrary to their goal to have that discussion so that aligned the second is around transparency you mentioned it very nicely around because everyone is clear on what that cost is. the consumer and health care professionals it is common to have discussions with the primary care physicians in our network who ordered medication setter on the formulary that had no idea how much that drug costs before the wrote the prescription than the patient came back and complains. the transparency around that is important and the methodology and payment mechanism with the desired outcome not just the process >> with respect to comparisons internationally there is great diversity around the world but also cross-country's but there is one uniform rule that in systems that rely on a price setting system to keep their costs under control, the effectiveness it is very predictable -- predictable it is a flight control and reduces the supply of very expensive car
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